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Canadian Journal of Infectious Diseases
Volume 8 (1997), Issue 2, Pages 95-98
Original Article

Survey of Physicians Concerning the Use of Chest Radiography in the Diagnosis of Pneumonia in Out-Patients

Thomas J Marrie

Departments of Medicine and Microbiology, Dalhousie University and Victoria General Hospital, Halifax, Nova Scotia, Canada

Received 23 February 1996; Accepted 30 July 1996

Copyright © 1997 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


OBJECTIVE: To determine how physicians use chest radiography in the diagnosis of pneumonia in ambulatory patients.

STUDY POPULATION: A convenience sample of 176 Nova Scotia family physicians and internists selected to represent all geographic areas of the province proportional to population.

STUDY INSTRUMENT: A 35-item questionnaire covering demographics, experience with out-patients with pneumonia, use of chest radiographs to make this diagnosis and factors that were considered important in the decision to perform initial and follow-up chest radiographs. Two skill-testing questions were also included.

RESULTS: One hundred and fourteen of 176 (64.7%) responded; 88% had treated out-patients with pneumonia in the previous three months. Fifty-seven per cent of physicians requested chest radiographs on 90% to 100% of out-patients in whom they had made a clinical diagnosis of pneumonia. These physicians were more likely to be internists and to have graduated before 1970. Factors that ranked most important in the decision to request the initial chest radiograph were clinical appearance, respiratory distress and physical findings, while age and smoking history contributed most to the decision to perform a follow-up chest radiograph.

CONCLUSIONS: There is considerable variability among physicians in requesting chest radiographs on out-patients with a clinical diagnosis of pneumonia. Physician and patient factors contribute to this variability.